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The northern region of Portugal has the largest number of companies manufacturing granite and stone products, which has become the region's trademark. In the municipalities of Marco de Canaveses and Penafiel, the economic activity of this area is important. However, the lack of attractiveness of this activity, combined with the high prevalence of silicosis and tuberculosis in this population, has led to a growing shortage of labor. In order for this project to be the result of collaborative, integral work centered on the people who are the target of health promotion, we used the Participatory Health Research (PHR) approach, based on the PRECEDE-PROCEED model, to implement a mixed-methods study, including participant observation, interviews and document analysis. These data were used to co-create a study design. In 2021, a total of 102 interviews were carried out and self-completion surveys were distributed: the Fantastic Lifestyle Questionnaire (FLQ) and the EQ-5D-3L. Within the scope of occupational health nursing and in the field of action of public health nurses, with the interviews and self-completed surveys carried out, we identified potential focuses for occupational health nursing intervention to promote the health of stone industry workers: adherence to protective measures, energy balance deficit, tobacco and alcohol consumption and access to health services. Data analysis made it possible to assess the prevalence of risk behaviors by order and to involve managers and workers in the co-creation of a health promotion program. The accurate identification of the focuses for nursing intervention not only improves the effectiveness of occupational health services, allowing for targeted interventions adapted to workers' needs, but also contributes considerably to health promotion in the workplace, resulting in safer working environments, a reduction in occupational diseases and, consequently, a healthier and more productive workforce. This protocol of this study was not registered. [ABSTRACT FROM AUTHOR]

Background: Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods: A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 – 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results: The study included 75 patients. Median PD was 25 days (IQR 11.5–63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05–2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77–2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14–4.82)], while living in Oporto [PR 0.35 (95% CI 0.16–0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17–0.94)] were protective factors. Conclusions: These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD. [ABSTRACT FROM AUTHOR]

The news media in Portugal played an important role during the COVID-19 pandemic by providing people with important and up-to-date health information. However, the number of news reports did not always correspond to the severity of the pandemic. There was significant media attention at the beginning of the pandemic (in early 2020), but media coverage soon declined, and the Portuguese media began to report on a greater diversity of topics. The present study assessed the evolution of news reports in Portugal during the period of the COVID-19 pandemic by analysis of epidemiological data (cases, deaths, and hospitalizations) and television news lineups from the three major generalist television channels, RTP1, SIC, TVI. The study period was from March 2020 (when the first lockdown was instituted) to March 2021 (when there was the second gradual withdrawal of restrictions). Our results indicated that there was intense media coverage of COVID-19 during the first phase of the pandemic, even though epidemiological data showed there was not a severe health crisis at that time. However, the number of news stories about the pandemic soon declined, and this number was much lower during the worst period of the pandemic. Hence, the intensity of coverage of the COVID-19 pandemic in the Portuguese media provided a distorted image of the actual pandemic. All things considered, we strongly advise for the inclusion of a communication plan that would help address future health emergency crisis. All things considered, we recommend that in future health crisis there is a planned communication strategy that takes into account media relations. [ABSTRACT FROM AUTHOR]

This work aims to provide a more complete characterization of coastal erosion mitigation and climate change adaptation measures by presenting a participatory approach that integrates medium- to long-term perspectives, considering simultaneously social, environmental, economic and engineering dimensions to help decision makers implement sustainable climate change adaptation (CCA) strategies. The work lists, explains and characterizes existing climate change mitigation and adaptation measures as well as their costs and positive and negative social, environmental and economic impacts, in three distinct databases. These databases are discussed, complemented and validated in participatory moments with local stakeholders of the Ovar Municipality, Portugal, which represents the case study to support the proposed methodology. Although Ovar is a pilot case, the integrated framework for resilient CCA has a global application with respect to methodologies and concepts. The proposed approach is useful to help coastal management entities to engage in more efficient, effective and beneficial planned action to mitigate coastal erosion and adapt to future climate change effects. The open-source databases and the participatory approach facilitate decision makers and coastal communities to navigate the complexity of solutions and build consensus around collective actions for coastal areas. [ABSTRACT FROM AUTHOR]

Climate change may be a game-changer for scientific research by promoting a science that is grounded in linking the production of knowledge and societal action in a transition toward more sustainable development pathways. Here, we discuss participatory action-research (PAR) as a way of thinking and leading investigations that may promote incremental and transformative changes in the context of climate change adaptation research. Our exploration is addressed in the Portuguese context, where PAR and sustainable transition studies are still marginal, and adaptation processes are a recent topic on political agendas. We describe the characteristics of PAR and use two studies of adaptation to illustrate how research and practice co-evolve through interactive cycles. The two studies are works in progress, rather than completed PAR processes. Climate change adaptation is an ongoing and long-term process. Moreover, in Portugal, as in many regions of the world, climate change adaptation is a fairly new topic. Thus, both case studies are now initiating a long-term process of change and adaptation. The completion of one research cycle is a realistic expectation that we have achieved in the two case study experiences. In our discussion of the case studies, we consider how these experiences provide insights into the role of PAR for long-term regime changes. We conclude by pointing to the societal needs addressed by PAR, as a pragmatically oriented and context-specific research design. The approach can be complementary to other frameworks in sustainable transition studies such as transition management. Being more pragmatically oriented, PAR cycles may influence incrementally transformative changes that can be guided by transition management's long-term design for governing sustainable transitions. [ABSTRACT FROM AUTHOR]

Robust strategies and action-plans are essential in tackling climate change. Given the local and context-specific nature of climate impacts, the involvement of municipalities is key for effective mitigation and adaptation solutions. Due to its vulnerability and low level of adaptive capacity, Portugal offers insights into adaptation research and practice in Europe. This article hypothesizes that National and European climate change adaptation strategies are not effectively involving municipalities, and are thus losing out on the opportunity to take stock of local responses for climate change mitigation and adaptation. To address this issue, a survey by questionnaire was done to Portuguese municipalities, and data was collected regarding the following: the importance attributed to climate change; the mitigation and adaptation measures planned and implemented; the main drivers, concerns, and triggers promoting climate policy and actions; and access to information and knowledge. 109 valid responses were collected across the country from a universe of 308 municipalities. Results show climate change in planning agendas is still ‘little’ or ‘not important’. There is also a clear difference in the drivers and concerns motivating climate policy, and action between Littoral and Inland regions. Overall, there is a greater focus on mitigation than adaptation. The discussion highlights the need for capacity building, the issue of equity, the role of European networks, and the relevance of cultural differences between Littoral and Inland regions. The conclusion distils the main lessons learned concerning these challenges and needs, the role of transnational networks, and the cultural contexts for building resilience, through adaptation, across Europe. [ABSTRACT FROM AUTHOR]

Climate change may be a game-changer for scientific research by promoting a science that is grounded in linking the production of knowledge and societal action in a transition toward more sustainable development pathways. Here, we discuss participatory action-research (PAR) as a way of thinking and leading investigations that may promote incremental and transformative changes in the context of climate change adaptation research. Our exploration is addressed in the Portuguese context, where PAR and sustainable transition studies are still marginal, and adaptation processes are a recent topic on political agendas. We describe the characteristics of PAR and use two studies of adaptation to illustrate how research and practice co-evolve through interactive cycles. The two studies are works in progress, rather than completed PAR processes. Climate change adaptation is an ongoing and long-term process. Moreover, in Portugal, as in many regions of the world, climate change adaptation is a fairly new topic. Thus, both case studies are now initiating a long-term process of change and adaptation. The completion of one research cycle is a realistic expectation that we have achieved in the two case study experiences. In our discussion of the case studies, we consider how these experiences provide insights into the role of PAR for long-term regime changes. We conclude by pointing to the societal needs addressed by PAR, as a pragmatically oriented and context-specific research design. The approach can be complementary to other frameworks in sustainable transition studies such as transition management. Being more pragmatically oriented, PAR cycles may influence incrementally transformative changes that can be guided by transition management's long-term design for governing sustainable transitions. [ABSTRACT FROM AUTHOR]

Abstract: Age estimation of living individuals has become one of the big issues of forensic anthropology. The increase of children and adolescents with no valid proof of their chronological age is a legal concern to many countries, especially in situations of illegal immigration, sub adult delinquency and juvenile work. For this purpose, the use of radiological methods for evaluation of skeletal maturation is particularly useful. In this study we compare the two of the most common methods applied in age estimation by hand/wrist radiographs: the Radiographic Atlas of Skeletal Development of the Hand and Wrist made by Greulich and Pyle (GP), 1959,and the Sempé method developed for computer – Maturos 4.0 (MT) program. These methods were applied to a sample of 230 radiographs of the hand and wrist from Portuguese children and adolescents of known sex age and age, aged between 12 and 20 years, who performed medical examination at the University of Coimbra Hospitals during 2005. The methods achieved different performances, depending on the age group. Between 12 and 15 years the bone age with the MT program is closer to the chronological age, whereas in older ages the GP Atlas method is more trustworthy. At the ages with legal consequences in Portugal (16 and 18 years) the GP Atlas method is most accurate, namely to decide whether an individual is younger or older than 18 years. Around 16 years old, although there are doubts in relation to the accuracy of both methods, GP Atlas seems to perform better. [Copyright &y& Elsevier]